WO2022147361A1 - Systèmes et procédés de découpe de tissu biologique dur et mou à l'aide d'énergie rayonnante et de colorants - Google Patents

Systèmes et procédés de découpe de tissu biologique dur et mou à l'aide d'énergie rayonnante et de colorants Download PDF

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Publication number
WO2022147361A1
WO2022147361A1 PCT/US2021/065838 US2021065838W WO2022147361A1 WO 2022147361 A1 WO2022147361 A1 WO 2022147361A1 US 2021065838 W US2021065838 W US 2021065838W WO 2022147361 A1 WO2022147361 A1 WO 2022147361A1
Authority
WO
WIPO (PCT)
Prior art keywords
laser
handpiece
dye
rinse
nozzle
Prior art date
Application number
PCT/US2021/065838
Other languages
English (en)
Inventor
Steven D. Jensen
Original Assignee
Cao Group, Inc
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Cao Group, Inc filed Critical Cao Group, Inc
Priority to US18/270,676 priority Critical patent/US20240065761A1/en
Priority to CN202180088868.XA priority patent/CN116801827A/zh
Priority to JP2023539942A priority patent/JP2024502026A/ja
Priority to KR1020237025909A priority patent/KR20230159369A/ko
Priority to EP21916561.0A priority patent/EP4271298A1/fr
Publication of WO2022147361A1 publication Critical patent/WO2022147361A1/fr

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/18—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves
    • A61B18/20—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/18—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves
    • A61B18/20—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser
    • A61B18/22—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser the beam being directed along or through a flexible conduit, e.g. an optical fibre; Couplings or hand-pieces therefor
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00571—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for achieving a particular surgical effect
    • A61B2018/00577—Ablation
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00571—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for achieving a particular surgical effect
    • A61B2018/00601—Cutting
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/18—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves
    • A61B18/20—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser
    • A61B2018/2015—Miscellaneous features
    • A61B2018/202—Laser enclosed in a hand-piece
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/18—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves
    • A61B18/20—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser
    • A61B18/22—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser the beam being directed along or through a flexible conduit, e.g. an optical fibre; Couplings or hand-pieces therefor
    • A61B2018/2255—Optical elements at the distal end of probe tips
    • A61B2018/2266—Optical elements at the distal end of probe tips with a lens, e.g. ball tipped
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/18—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves
    • A61B18/20—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser
    • A61B18/22—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser the beam being directed along or through a flexible conduit, e.g. an optical fibre; Couplings or hand-pieces therefor
    • A61B2018/2255—Optical elements at the distal end of probe tips
    • A61B2018/2272—Optical elements at the distal end of probe tips with reflective or refractive surfaces for deflecting the beam
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C1/00—Dental machines for boring or cutting ; General features of dental machines or apparatus, e.g. hand-piece design
    • A61C1/0046—Dental lasers

Definitions

  • the present invention relates to the field of surgical instruments and more particularly relates to a surgical cutting tool which both applies a dye and a laser attuned to the dye to a surface to be cut.
  • the present invention is a novel advancement in the art that utilizes a high- powered laser coupled with a matching wavelength absorptive dye, stain, or pigment to adjust absorption rate of tissue to the laser and make cutting efficiently at lower energy without generating excessive heat.
  • the present invention represents a departure from the prior art in that the laser cutting system of the present invention allows for direct application of a dye, laser, and rinse solution to tissues desired to be cut with the same tool.
  • an improved laser cutting system may provide a system that meets the following objectives: that it be able to cut both hard and soft tissue, that it be simple to operate and manufacture, and that it would generate less heat than traditional systems.
  • a new and improved laser system may comprise a mechanism to deliver a laser beam to a cutting surface, a mechanism to apply a dye to the cutting surface, and a mechanism to deliver a rinsing solution to the cutting surface to clean off the debris caused by cutting the targeted tissues.
  • the dye should have a high absorption efficiency in relation to the emitted laser energy.
  • the method of cutting a targeted tissue structure is simple. First, a dye solution is applied to the targeted surface through the dye application mechanism.
  • a laser beam having a proper power output and pulse rate is applied to the dyed surface, resulting in ablation of the surface.
  • a solution may be applied to clean off the dye and debris from ablation. This sequence is repeated until the desired cutting is achieved and all three steps are completed with the same tool and handpiece.
  • the invented method will cut all the tissues efficiently at lower laser energy with fewer heat issues.
  • Figure 1 is a schematic drawing of a laser cutting system utilizing an embodiment of the invention.
  • Figure 2 is a close-up schematic of the head of the laser cutting system in FIG. 1.
  • Figure 3 is a schematic depicting an alternate head design, with reservoirs for liquids stored therein.
  • Figure 4 is another schematic depicting an alternate head design, with reservoirs for liquids stored therein.
  • Figure 5 is another schematic depicting an alternate head design, with reservoirs for liquids stored therein.
  • the present invention utilizes a laser, dye spray applicator, and a rinse spray applicator together in concert to create a computer programmable system that delivers a precise means of controlled ablation.
  • the laser module, spray applicator and rinse applicator are integrated into a single unit that is activated by the main interface, a foot switch or hand piece.
  • the laser portion comprising a laser module that is coupled to a fiber optic cable or tip, wherein the coherent radiant energy is delivered directly to the treatment site.
  • the dye spray activator comprises a liquid dye storage container and a pump, which is connected by means of tubing to a nozzle that is designed to spray a pattern of stain onto the treatment site that best matches the radiant energy footprint from the fiber optic.
  • the rinse applicator comprises a rinsing liquid storage container and a pump that is connected by means of tubing to a nozzle that is designed to rinse the treatment site.
  • the nozzles of the stain and rinse applicators can be attached directly to the end of the fiber optic cable or hand piece such that by simply aiming the laser all 3 steps of dye application, laser initiation, and rinsing can be done continuously in succession by triggering the foot switch or other triggering device, thereby allowing the operator to continuously ablate as desired.
  • the integrated system is controlled by means of a programmable computer module that controls the laser power output and the duration of the pulse; it also controls the pump for both the stain applicator and the rinse applicator such that a precise amount of the liquid components and/or the duration of flow can be precisely controlled and delivered at the specified time.
  • a laser system to cut both hard and soft tissue (100) has a casing (101 ) with a display (102) for laser system information and control.
  • An emergency stop button (103) may be provided to intervene laser at any given time.
  • a power supply (104) to provide power to the system is depicted, however the system can also be rechargeable battery operated.
  • the system may be controlled by any means, however a wireless footswitch (108) is commonly utilized to control emission of the laser system (100). Controls may also be positioned on the handpiece itself.
  • a multifunction cable (105), containing fiber waveguide for a laser beam, electrical wires, and tubing to deliver desired liquids, is also connected to the system, and runs through hand piece (106) which is held by the operator.
  • Handpiece (106) supports multifunction cable (105) and presents exits of for the laser beam and liquids (107).
  • a laser beam is generated from a laser module generated inside the laser system casing.
  • the liquids can be transported through cable (105) from liquid reservoirs inside the system or may be stored in micro cartridges placed in the handpiece (107).
  • the handpiece has a head (200), which may be one of many different embodiments.
  • a head (200) which may be one of many different embodiments.
  • FIG. 2 featuring a casing (201 ) with distal end (202) and an exit (203) for laser (206) and liquids.
  • a microvalve (204) connected to tubing (207) to deliver dye to microvalve (204), with a nozzle (205) for delivery.
  • the dye is stored in a reservoir in the laser system.
  • the emission of the dye is controlled by microvalve (204) through nozzle (205) to form a dye jet (209) to apply the dye to the treatment surface (210).
  • microvalve (211 ) with a nozzle (212) of a rinse agent.
  • tubing (213) delivers the rinse solution to microvalve (211 ) from a reservoir in the laser system.
  • wire harness (214) connected to the microvalve (211 ) for control.
  • the emission of the rinse solution is emitted through nozzle (212) as a rinse jet (215) to the treatment surface (210).
  • the laser (206), dye jet (209), and rinse jet (215) may be focused on a single spot area of the treatment site, as is shown in FIG. 2.
  • the laser beam will have certain wavelength and power.
  • the wavelength can be one of followings: any wavelength can be generated by semiconductor lasers, any wavelength that can be generated by diode pumped lasers, any wavelength that can be generated by solid state lasers, any wavelength that can be generated by gas lasers.
  • the power output of laser beam can be ranged for 1W to 100W.
  • the laser being selected to produce a narrow wavelength of coherent light such that it can be matched to a dye that will absorb the energy at an efficiency of greater than 50%, and more especially at an efficiency above 90%.
  • the radiant energy is produced by various means as described, but the preferred radiant energy source is a diode laser.
  • the cutting implements according to present invention may utilize laser density as low as 1 watt and up to about 100 watts output.
  • the laser output can be in continuous or pulsed format depending on the requirements of laser power and dye to be used.
  • the first liquid in the system is a dye, stain, or pigment that efficiently absorbs radiant energy and transforms it back into heat. Collectively, these will be referred to as “dyes.”
  • dyes include, but are not limited to, are: carbon black, FD&C Blue #2, nigrosin, FD&C black shade, FD&C blue #1 , methylene blue, FD&C blue #2, malachite green, D&C green #8, D&C green #6, D&C green #5, ethyl violet, methyl violet, FD&C green #3, FD&C red #3, FD&C red #40, D&C yellow #8, D&C yellow #10, D&C yellow # 11 , FD&C yellow #5, FD&C yellow #6, neutral red, safranine O, FD&C carmine, rhodamine G, napthol blue black, D&C orange #4, thymol blue, auramine O, D&C red #2
  • the preferred dye is one that is deemed biologically compatible or non-toxic and may include any of the above dyes as an ingredient in a final solution.
  • Other dyes currently existing or discovered or manufactured in the future, may be readily utilized in this method. Therefore, the above listing should not be considered definitive, but illustrative of dyes to be utilized in the disclosed method and in no way be considered limiting.
  • the second liquid in the system is a liquid that can wash off the dyes after laser interaction from tissue.
  • An embodiment of the present invention utilizes a washing or rinsing step that is designed to remove residual decomposition and contamination components from the treatment site after the dye and laser steps have initiated and fired. These actions will produce residual contaminants, including by-products of combustion and thermally decomposed tissue, which need to be removed from the treatment site. If these contaminants are not removed, they will significantly decrease the efficiency of the next laser/dye cycle.
  • a rinse or wash step is designed to remove these contaminants before the next cycle begins. Examples of rinsing solvents and solutions include but are not limited to water; solutions of salts in water, such as sodium chloride; alcohol solutions; poly-ol solutions; surfactants; and any other useful rinsing agent.
  • the dye in liquid form is systematically micro-sprayed onto the treatment site as a pulse.
  • the laser is triggered, and a pulse of radiant energy is directed to the treatment site where it is absorbed by the liquid dye, creating extreme localized heating. This heating causes rapid expansion, and a micro explosion soon follows which cuts both the hard and soft tissue.
  • a cleansing spray is pulsed over the treatment site to wash and clean the treatment site before the entire process is repeated in rapid succession thus creating a system to cut biological tissue efficiently and precisely.
  • the dyes are specifically selected to efficiently match the output of the radiant energy source and thus maximize energy absorption. This efficient absorption translates the energy into faster heat conversion and better cutting efficiency.
  • FIG. 3 An alternate handpiece construction is shown in FIG. 3, where (300) is a handpiece for the laser system, with (301 ) being a handpiece casing with a proximal end and distal end (302) with an exit (303) for laser (307), dye (209), and rinse solution (315).
  • a fiber (304) from laser system to deliver a laser beam.
  • This fiber cable (304) is turned 90° (305) and ends before the handpiece exit.
  • the laser beam can be optically shaped into a replaceable fiber tip (306) which delivers the laser beam (307) to the treatment surface (308).
  • the handpiece contains two liquid cartridges (309), (313) located proximate laser tip (306).
  • Cartridge (309) contains a dye solution and has a nozzle (310) positioned to spray a dye jet (311 ) on the treatment surface (308).
  • a wire (312) connected the cartridge (309) to the laser system to control emission of the dye jet (311 ).
  • the amount of solution injected from cartridge and speed are controlled electronically.
  • Rinse cartridge (313) contains rinse solution and like the dye cartridge has a nozzle (314) positioned to spray the rinse solution (315) on the treatment surface (308).
  • the amount of solution injected from cartridge and speed are controlled electronically. Both cartridges (309), (313) are replaceable when the liquids in the cartridge are consumed.
  • FIG. 4 Other systems may adapt how the laser is delivered, such as the embodiment shown in FIG. 4.
  • the deliveries of dye and rinse solutions are the same as described in FIG. 3, where (401 ) is the casing of handpiece with distal end (402) and exit (403) for laser beam, dye, and rinse solutions.
  • a fiber (404) to deliver the laser beam (405) and at end of fiber (404) is a lens (406) to shape the beam. Beam may be focused or shaped into a parallel, collimated, beam (407).
  • a reflector (408) is used to reflect the beam (407) by a 90° angle, thereby directing beam (409) to treatment surface (410).
  • FIG. 5 Further variation on the laser direction is shown in FIG. 5.
  • the deliveries of dye and rinse solutions are the same as described in FIG. 3, but the laser (506) is delivered through a fiber (504) that is bent 90° (505) and is then directed to lens (507) which adjusts the beam (508).
  • Beam (508) may be a focused or parallel beam when is strikes the treatment surface (509).

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  • Health & Medical Sciences (AREA)
  • Physics & Mathematics (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • Animal Behavior & Ethology (AREA)
  • Optics & Photonics (AREA)
  • Veterinary Medicine (AREA)
  • Public Health (AREA)
  • General Health & Medical Sciences (AREA)
  • Otolaryngology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Biomedical Technology (AREA)
  • Engineering & Computer Science (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Electromagnetism (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Dentistry (AREA)
  • Epidemiology (AREA)
  • Laser Surgery Devices (AREA)
  • Surgical Instruments (AREA)

Abstract

La présente invention concerne un système laser pour tissus biologiques durs et mous qui utilise un laser (206), un applicateur de pulvérisation de colorant (205) et un applicateur de pulvérisation de rinçage (212) en accord dans une seule pièce à main (200) pour créer un système programmable par ordinateur qui délivre un moyen précis d'ablation contrôlée. La pièce à main (200) est d'abord utilisée pour appliquer un colorant (209) sur une surface de traitement ciblée (210). Ensuite, elle est utilisée pour appliquer un faisceau laser à la surface de traitement colorée. Ceci est suivi par l'application d'un agent de rinçage (215) par la même pièce à main (200) pour éliminer les débris et les sous-produits de combustion. Les étapes sont ensuite répétées jusqu'à la fin de l'opération.
PCT/US2021/065838 2020-12-31 2021-12-31 Systèmes et procédés de découpe de tissu biologique dur et mou à l'aide d'énergie rayonnante et de colorants WO2022147361A1 (fr)

Priority Applications (5)

Application Number Priority Date Filing Date Title
US18/270,676 US20240065761A1 (en) 2020-12-31 2021-12-31 Systems and methods of cutting hard and soft biological tissue utilizing radiant energy and dyes
CN202180088868.XA CN116801827A (zh) 2020-12-31 2021-12-31 利用辐射能量和染料切割硬的生物组织和软的生物组织的系统和方法
JP2023539942A JP2024502026A (ja) 2020-12-31 2021-12-31 放射エネルギーおよび染料を利用して生体硬組織および軟組織を切断するシステムおよび方法
KR1020237025909A KR20230159369A (ko) 2020-12-31 2021-12-31 복사 에너지 및 염료를 사용하는 경질 및 연질 생물학적조직을 절단하는 시스템 및 방법
EP21916561.0A EP4271298A1 (fr) 2020-12-31 2021-12-31 Systèmes et procédés de découpe de tissu biologique dur et mou à l'aide d'énergie rayonnante et de colorants

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US202063133057P 2020-12-31 2020-12-31
US63/133,057 2020-12-31

Publications (1)

Publication Number Publication Date
WO2022147361A1 true WO2022147361A1 (fr) 2022-07-07

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PCT/US2021/065838 WO2022147361A1 (fr) 2020-12-31 2021-12-31 Systèmes et procédés de découpe de tissu biologique dur et mou à l'aide d'énergie rayonnante et de colorants

Country Status (6)

Country Link
US (1) US20240065761A1 (fr)
EP (1) EP4271298A1 (fr)
JP (1) JP2024502026A (fr)
KR (1) KR20230159369A (fr)
CN (1) CN116801827A (fr)
WO (1) WO2022147361A1 (fr)

Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5976123A (en) * 1996-07-30 1999-11-02 Laser Aesthetics, Inc. Heart stabilization
US20080032251A1 (en) * 2006-07-19 2008-02-07 Mau-Song Chou Laser carious region ablation
US20100092908A1 (en) * 2008-10-10 2010-04-15 W&H Dentalwerk Burmoos Gmbh Medical handpiece with pulsed illumination
WO2020241633A1 (fr) * 2019-05-27 2020-12-03 国立大学法人三重大学 Procédé de détection de lésion

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5976123A (en) * 1996-07-30 1999-11-02 Laser Aesthetics, Inc. Heart stabilization
US20080032251A1 (en) * 2006-07-19 2008-02-07 Mau-Song Chou Laser carious region ablation
US20100092908A1 (en) * 2008-10-10 2010-04-15 W&H Dentalwerk Burmoos Gmbh Medical handpiece with pulsed illumination
WO2020241633A1 (fr) * 2019-05-27 2020-12-03 国立大学法人三重大学 Procédé de détection de lésion

Also Published As

Publication number Publication date
JP2024502026A (ja) 2024-01-17
CN116801827A (zh) 2023-09-22
US20240065761A1 (en) 2024-02-29
EP4271298A1 (fr) 2023-11-08
KR20230159369A (ko) 2023-11-21

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